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    #1

    Copaxone and Shared Solutions

    I thought about applying for the prescription copay assistance. I cannot do the $35 assistance, but the other one they offer. Because my card has to be used at a specific pharmacy in my area only.

    But Im wondering if their is any catch that I should be aware of. I have presciption coverage but my copay is over $300 each month.

    If I would stop the drug midway are they going to bill me for the rest of the year? the full drug amount?

    I have just become very leery of these pharmaceutical companies, because their job is to make money so what is in it for them?
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    #2
    What is in it for them is over $3000 they will get from your insurance if they pay your copay and keep you on the drug.

    I just got off of Copaxone, and they paid my copay each month the entire time, and with no financial need demonstrated. Who are you worried would bill you if you stop the meds? You order a month of meds, they pick up the copay, insurance (hopefully) covers the rest. Rinse, repeat.

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      #3
      copay copaxone

      If your copay is less than $500 per month, they will put you on their $35 per month copay. If your co-pay is over $500, they will give you $500 towards your copay.

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        #4
        I am not completely sure of your situation. I did not have insurance for a while and I applied for assistance. I didn't have to pay anything.

        I might have just gotten lucky. My financial situation got pretty yucky after my employer let me go and long term disability would not pay. Wow - I used lucky to describe that?

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          #5
          Originally posted by GracieBH View Post
          I thought about applying for the prescription copay assistance. I cannot do the $35 assistance, but the other one they offer. Because my card has to be used at a specific pharmacy in my area only.

          But Im wondering if their is any catch that I should be aware of. I have presciption coverage but my copay is over $300 each month.

          If I would stop the drug midway are they going to bill me for the rest of the year? the full drug amount?

          I have just become very leery of these pharmaceutical companies, because their job is to make money so what is in it for them?
          If you're referring to their "frequent flyer" program (can't remember what it was actually called, I just think of it that way) where they pay for the drug or most of the drug, but expect you to stay on it, it isn't as if you're responsible for drugs you won't be taking.

          What they want you to do is order the drug every month in a timely manner (unless there is a medical reason). They don't want you skipping months or refilling weeks late. If you skip or refill late, you may lose eligibility for the program and then have to pay your usual insurance co-pay. If you stop taking Copaxone, you just stop taking it. Simple as that.

          The reason they do it that way is because if you use insurance alone, you may or may not order every month. Maybe you'd got to every other day or delay refilling to economize. You might even decide you won't take it anymore. With insurance alone, they risk getting only a portion of what they'd get if they simply accepted what your insurance pays with a smaller copay from you, provided you agree to order it every month as long as you are supposed to be taking it.

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            #6
            Question about copay program

            Are you saying that Shared Solutions will get the insurance reimbursement rather than the pharmacy that was used previously? If so, are the insurance companies okay with this? Mine restricts what pharmacy I go to for specialized drugs.

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              #7
              Originally posted by its2much View Post
              Are you saying that Shared Solutions will get the insurance reimbursement rather than the pharmacy that was used previously? If so, are the insurance companies okay with this? Mine restricts what pharmacy I go to for specialized drugs.
              Shared Solutions is only the patient support program for Copaxone, manufactured by Teva. Your pharmacy buys their supply from Teva. It isn't like aspirin or ibuprofen, which is easily and inexpensively purchased and stocked in a variety of brands by every pharmacy there is.

              Specialty pharmacies must buy Copaxone from Teva and that's done often at the time an rx comes in. It's not, after all, something that they have a large market for or can stock up on, exactly.

              Eventually, a large part of what your insurance and you pay to the pharmacy goes to them through the pharmacy's purchase of Copaxone from Teva to supply to you.

              It's just like anything else you buy in a store. Store buys from Manufacturer and you buy from Store. Your purchase paid for the cost of the item to the store (covering what they have paid the manufacturer for the item) and provided them with a profit. Both make money on the sale.

              In this case, it's that specialty pharmacy and Teva that get the insurance co's money. Which is why, we are back again to these programs. It is their best interest,as well as the pharmacies who agree to work with these programs, to get you and keep you on their drug.

              Every one makes more money and the pharmacy doesn't get stuck with drugs they ordered to supply patients who now can't take it for some financial reason.

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                #8
                Thank you for the replies. I'm still waiting for the final approval. Been off Copaxone a week, been weird not injecting myself. So hopefully I will hear soon.

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                  #9
                  Shared Solutions Copay

                  I would love to be able to be back on the medication but $500(copay) is not enough to help me. Everyday my legs get weaker - balance is getting worse - cognitive impairments as well. Tingling in new parts of my body.

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                    #10
                    Gracie

                    Did you apply for financial assistance through Shared Solutions or someone else?

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                      #11
                      I went thru Shared Solutions, so right now I am waiting for them to run it thru my insurance to see what they can do.

                      Been a week now, kind of like not having the shots but almost feel like something is missing.

                      I believe I may have had a little bit of a relapse because the stress load hit the fan and that happens whenever I become too stressed.

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                        #12
                        Good Luck to you, Gracie!

                        I'll cross my fingers it all works out for you. Please let us know. There's another thread regarding copaxone and insurance. Waiting for an answer from jmerced about thier experience with shared solutions.

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                          #13
                          I was approved by Shared Solutions and will be able to restart my Copaxone tonight. I was getting use to no shots but since it has worked so far I will go back on it.

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                            #14
                            Great News for You

                            Would you mind sharing what your cost will now be for copaxone? Youcan email me at ****e-mail address removed from post as per our guideines. You may put it in your profile****, if you would rather not post this information. Thank you. I just wish I could get back on it...

                            Comment

                              #15
                              They are paying my monthly copay which is just a little under $400. Last time i checked the actually drug was costing approx $4500. a month.

                              I do appreciate Shared Solutions help, but I also have to say the financial cost of ANY of the MS drugs are unreasonable.

                              No person could afford their treatment without financial help or assistance (unless they are rich).

                              Comment

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